Footling Breech

[cib77]

In a dilemma. I had a straightforward normal delivery the last time. This time baby has decided to be awkward and is footling breech and has been since 28 weeks I think. I'm 34+1 now so chances of her turning now are getting slimmmer by the day! I also have an anterior placenta. I have read up quite a bit on ecv and the success rate is pretty high, especially for multips, although I do know that footlings are less likely to turn successfully and having an anterior placenta can make fetal parts more difficult to feel. I keep worrying about abruption or needing an emergency c-section even though the risk is low. For some reason I feel really anxious about it and at present I think I'd prefer an elective section although as a GP myself I'd advise my patients to go for ECV! On paper ECV seems like the much more sensible option. I'd be really interested to hear about peoples experiences as well.

 

[QueenQueso]

My first was frank breech.

Normal pregnancy, don't recall the position at the 20w scan, but I didn't have another one after that. I remember asking the cnm at one point (maybe around 36 weeks?) if baby was breech or head down, and after palpitating, she said he was head down. I asked the question because my SIL had been pregnant at the same time, she had her baby two months before me, and she had complained non-stop about tiny little feet digging up under her ribs, and I never had that. Instead, I had a big bulge. The midwife said it was the baby's bottom.

At my 41w appt, she gave me the option of doing an u/s the next day and going from there, or just scheduling an induction to be done 5 days from then, if I hadn't gone into labor yet. I chose the induction. At my hospital, they have you check in late in the evening and get settled in, and then they place a medicated patch on your cervix. You sleep with it in, I guess sometimes it's enough to kickstart labor if you're already close, and then in the early morning, like 6/7 am, they hook up the Pitocin and get started. Part of the 'settling in' is being hooked up to a fetal heart monitor and while the nurse was placing that, she was talking about how it was hard to get it lined up right and wondered if perhaps he was face up instead of face down (face down is normal labor position, and it puts their back against your belly so the hb is easier to get) and I mentioned wondering if he was breech.

She thought we'd better double-check and wheeled in the portable u/s machine. After a moment, she went ahead and paged the OB on call, who was my own OB. And yep, frank breech and face up, tipped kind of sideways. The big bulge under my right rib was his head and his feet were up directly at the top center, knees were locked, and there was almost no fluid left. After reviewing it, the OB said that there was a really small chance that an EV would work at all, because of the little amount of fluid, and it was too bad of a position to go ahead with the induction (my OB will deliver breech babies, but not frank breech. Not sure about footling.).

We went ahead and scheduled a cesarean for the next morning (as it was I think about 11 pm at that point) and I stayed the night since I had already signed in.

My next baby was in normal position, and I wanted a vbac, but they have a rule that you can't go more than a week past due so I had another cesarean at 41w1d. This one will be another rcs unless I go into labor early and everything goes perfectly.

Have you tried spinningbabies.com?

 

[Beanonorder]

I'm in the same position as you - footling breech and anterior placenta. I've decided against ecv. For one my doctor told me there is only about a 50% success rate and it does depend on the doctor. She said the anterior placenta does make it more difficult. I've heard it can be an incredibly painful procedure and it's expensive. My insurance won't cover it so I don't feel it's worth it.
I've been trying a few exercises to get him to turn but I'll be honest and say I haven't been as consistent as I should be. I'm trying to remedy that. The high risk consultant told me as long as I'm pregnant there is a chance he could turn. Poking around on here I've also seen people say their 9lb babies turned at 38 and 39 weeks! So I'm not giving up yet!

 

[NDH]

My second daughter was breech (Frank though, not footling). I initially didn't want an ECV as I felt it too low of a success ate and too much risk, but later I met with a Dr who attends breech births and after a conversation about his specific rates vs general internet ones I decided to go ahead with it after evaluating whether I would regret not trying it, or trying it and needing emergency cesarean more.
The Dr who preformed mine said that in 13 years their hospital has only had to perform 2 emergency cesareans following an ECV due to bub showing signs of distress from it, and in not cases baby was fine (but this is the reason ECVs arentdone before 37 weeks). Their success rates are lower than average at just 20%, but that was for babies who stayed head down after being turned - higher rates usually just include whether baby turned, and many will turn back to breech. Anyway I didn't find it bad at all. I was told gas was available if I needed it, but I didn't find it particularly painful, just uncomfortable. Bub was carefully monitored throughout and I was told that I was completely in control of the procedure.
Anyway it wasn't successful for me - her bum was fully engaged - but I'm glad I had it done. I did birth her vaginally because I was able to find a breech supportive Dr, but I definitely know what it's like being faced with seemingly no choice but a cesarean.
There are other methods you may wish to attempt to turn as well if you've not done them.

Moxibustion, which a TCM/acupuncturist can do
Webster's technique by a qualified chiropractor (my preferred method. High success rate but doesn't physically turn baby, just attempts to make it easier for them to turn on their own)
Homeopathic like puslitilla
Versions and breech tilts from spinningbabies.com

QueenQueso its interesting/unusual that you had a breech friendly Dr who wouldn't do Frank breech births. Frank breech is by far the easiest/least risky type of breech to birth vaginally. Frank breech is the hardest to turn with ECV (footling is the easiest) though.